DEPARTMENT OF HUMAN SERVICES OFFICE OF CHILD ...2020/07/01 · Definitions 413-020-0000 Definitions...

DEPARTMENT OF HUMAN SERVICES

OFFICE OF CHILD WELFARE PROGRAMS

CHAPTER 413

DIVISION 20

CASE MANAGEMENT

Updated 07/01/2020

TABLE OF CONTENTS

Definitions ................................................................................................................. 2

Voluntary Custody Agreement ............................................................................... 9

Voluntary Placement Agreement .........................................................................14

Guardian and Legal Custodian Consents ............................................................18

CANS Screening and Enhanced Supervision ......................................................25

Investigation of Suspected Medical Neglect ........................................................37

Definitions

413-020-0000

Definitions (Amended 11/1/2018)

The following definitions apply to OAR chapter 413, division 20.

(1) "Adoption assistance agreement" means a written agreement, binding on the parties to the

agreement, between the Department and the pre-adoptive family or adoptive family of an

eligible child or young adult, setting forth the assistance the Department is to provide on

behalf of the child or young adult, the responsibilities of the pre-adoptive family or

adoptive family and the Department, and the manner in which the agreement and amount

of assistance may be modified or terminated.

(2) "Adoptive family" means an individual or individuals who have legalized a parental

relationship to the child through a judgment of the court.

(3) "Age-appropriate or developmentally appropriate activities" means:

(a) Activities or items that are generally accepted as suitable for children or young

adults of the same chronological age or level of maturity or that are determined to

be developmentally appropriate for a child or young adult, based on the

development of cognitive, emotional, physical, and behavioral capacities that are

typical for an age or age group; and

(b) In the case of a specific child or young adult, activities or items that are suitable

for the child based on the developmental stages attained by the child or young

adult with respect to the cognitive, emotional, physical, and behavioral capacities

of the child or young adult.

(4) "BRS" means Behavior Rehabilitation Services, a Medicaid-funded program that

provides behavioral intervention, counseling, or skill building services in a professional,

shelter, or residential (including therapeutic foster care formerly referred to as proctor

care) placement setting.

(5) "CANS screener" means an individual, who performs CANS screenings under the

supervision of the Level of Care Manager or designee, and who annually completes the

training in the use of the Oregon CANS Comprehensive Screening Tool with a

documented reliability score of 0.70 or greater.

(6) "CANS screening" means Child and Adolescent Needs and Strengths screening, a

process of gathering information on the needs and strengths of a child or young adult:

(a) To identify case planning, service planning, and supervision needs of the child or

young adult in substitute care with a certified family;

DEFINITIONS OAR 413-020-0000

(b) To determine the level of care payment while in substitute care with a certified

family; and

(c) To determine if a child or young adult qualifies for a level of care payment for the

purpose of negotiating or renegotiating an adoption assistance or guardianship

assistance payment.

(7) “CANS rescreen” means a type of CANS screening that is completed when a child or

young adult is living with a certified family and the certified family has observed

ongoing, documented changes in behavior or functioning which:

(a) Have not improved after a revision of the supervision actions and activities

provided by the certified family and other individuals, and the last CANS

screening was completed more than 90 days prior to the rescreen referral date; or

(b) Endanger the safety of the child or young adult or the safety of others and the last

CANS screening was completed more than 90 days prior to the rescreen referral

date; or

(c) The child or young adult has undergone a major life event or transition.

(8) "Caseworker" means the agency staff person assigned primary responsibility for a child

or young adult served by the Department.

(9) "Certified family" means an individual or individuals who hold a current Certificate of

Approval from the Department to operate a home to provide care, in the home in which

he or she resides, to a child or young adult in the care or custody of the Department.

(10) "Certifier" means a Child Welfare employee who conducts assessments of applicants

interested in providing relative or foster care to a child or young adult in the care or

custody of the Department, determines whether or not to recommend approval of the

operation of a relative care or foster care home, and monitors the compliance of a relative

care or foster care home with Child Welfare certification rules.

(11) "Child" means a person under 18 years of age.

(12) "Department" means the Department of Human Services, Child Welfare.

(13) "Designated Consultant Neonatologist" means a neonatologist whose services are

available to Child Welfare to review medical information and consult with Child Welfare

and other experts deemed necessary in cases of suspected medical neglect.

(14) "Designated hospital liaison" means an individual, usually the hospital administrator,

designated by each respective hospital to assist Child Welfare with coordination,

consultation, and prompt notification of suspected cases of medical neglect.


(15) "Disabled infant" means a child of less than one year of age having a physical or mental

impairment which may substantially limit one or more major life functions such as

breathing, seeing, hearing, walking, caring for one's self, performing manual tasks,

learning, and working.

(16) "Enhanced supervision" means the additional support, direction, observation, and

guidance necessary to promote and ensure the safety and well-being of a child or young

adult when the child or young adult qualifies for a level of care payment.

(17) "Foster parent" means an individual who operates a home that has been approved by the

Department to provide care for an unrelated child or young adult placed in the home by

the Department.

(18) "Guardian" means an individual who has been granted guardianship of the child through

a judgment of the court.

(19) "Guardianship assistance" means assistance provided on behalf of an eligible child or

young adult to offset the costs associated with establishing the guardianship and meeting

the ongoing needs of the child or young adult. "Guardianship assistance" may be in the

form of payments, medical coverage, or reimbursement of nonrecurring guardianship

expenses.

(20) "Guardianship assistance agreement" means a written agreement, binding on the parties

to the agreement, between the Department and the guardian of an eligible child or young

adult setting forth the assistance the Department is to provide on behalf of the child or

young adult, the responsibilities of the guardian and the Department, and the manner in

which the agreement and amount of assistance may be modified or terminated.

(21) "Hospital Review Committee (HRC)" is a committee established by a medical facility or

hospital to offer counsel and review in cases involving a disabled infant with life-

threatening conditions.

(22) "Indian child" means any unmarried person who is under age 18 and either:

(a) Is a member or citizen of an Indian tribe; or

(b) Is eligible for membership or citizenship in an Indian tribe and is the

biological child of a member or citizen of an Indian tribe.

(23) "Legal custodian" means a person, agency, or institution with legal custody of a child and

all of the following duties and authority:

(a) To have physical custody and control of a child.

(b) To supply the child with food, clothing, shelter, and incidental necessities.

(c) To provide the child with care, education, and discipline.


(d) To authorize ordinary medical, dental, psychiatric, psychological, and other

remedial care or treatment for the child and, in an emergency where the child's

safety appears urgently to require it, to authorize surgery or other extraordinary

care.

(e) To make such reports and to supply such information as the court may require.

(f) To apply for any benefits to which the child is entitled and to use them to pay for

the child's care.

(24) "Legal custody" means that a person or agency has legal authority:

(a) To have physical custody and control of a child;

(b) To supply the child with food, clothing, shelter and other necessities;

(c) To provide the child with care, education and discipline;

(d) To authorize medical, dental, psychiatric, psychological, hygienic or other

remedial care or treatment for the child, and in any emergency where the child's

safety appears urgently to require it, to authorize surgery or other extraordinary

care; and

(e) "Legal custody" includes temporary custody of a child under an order of a court.

(25) "Level of care payment" means the payment provided to an approved or certified family

based on the child or young adult's need for enhanced supervision as determined by

applying the CANS algorithm to the results of the CANS screening.

(26) "Mechanical restraint" means the use of any physical device to involuntarily restrain the

movement of all or a portion of a child's body as a means of controlling his or her

physical activities in order to protect the child or other persons from injury. "Mechanical

restraint" does not apply to movement restrictions stemming from medicinal, dental,

diagnostic, or surgical procedures which are based on widely accepted, clinically

appropriate methods of treatment by qualified professionals operating within the scope of

their licensure.

(27) "Medical neglect" means the failure to provide adequate medical care, including the

withholding of medically indicated treatment, from a disabled infant with life-threatening

conditions.

(28) "Medical Neglect Investigator" means Child Welfare staff designated and trained to

provide consultation and complete investigations of alleged medical neglect reports.

(29) "Medically indicated treatment" means treatment (including appropriate nutrition,

hydration, and medication) which, in the treating physician's reasonable medical

judgment, is most likely to be effective in amelioration or correcting a life-threatening

condition. It does not include the failure to provide treatment other than nutrition,


hydration, or medication to an infant when, in the treating physician's reasonable medical

judgment, any of the following circumstances apply:

(a) The infant is chronically irreversibly comatose.

(b) The provision of such treatment would merely prolong dying, not be effective in

ameliorating or correcting all of the infant's life-threatening conditions, or

otherwise be futile in terms of survival of the infant.

(c) The provisions of treatment would be virtually futile in terms of the survival of

the infant and the treatment itself under such circumstances would be inhumane.

(30) "Participating tribe" means a federally-recognized Indian tribe in Oregon with a Title IV-

E agreement with the Department.

(31) "Permanent custody" means legal custody of a child:

(a) Who has been permanently committed to the Department by the juvenile court

after parental rights have been terminated under ORS 419B.527; or

(b) Who has been released and surrendered to the Department by the parents under

ORS 418.270.

(32) "Physical custodian" means a person or agency, including a child's legal or biological

parent, a relative, foster parent, adoptive parent, or a licensed child-caring agency who is

authorized by the Department to provide a residence and day-to-day care for a child who

is in the legal custody of the Department.

(33) "Physical restraint" means the act of restricting a child or young adult's voluntary

movement as an emergency measure to manage and protect the child or young adult or

others from injury when no alternate actions are sufficient to manage the child or young

adult's behavior. "Physical restraint" does not include temporarily holding a child or

young adult to assist him or her or assure his or her safety, such as preventing a child

from running onto a busy street.

(34) "Potential guardian" means an individual who:

(a) Has been approved by the Department or participating tribe to be a child's

guardian; and

(b) Is in the process of legalizing the relationship to the child through the judgment of

the court.

(35) "Pre-adoptive family" means an individual or individuals who:

(a) Has been selected to be a child's adoptive family; and

https://www.oregonlegislature.gov/bills_laws/lawsstatutes/2013ors419B.html

https://www.oregonlegislature.gov/bills_laws/lawsstatutes/2013ors418.html


(b) Is in the process of legalizing the relationship to the child through the judgment of

the court.

(36) "Reasonable and prudent parent standard" means the standard, characterized by careful

and sensible parental decisions that maintain the health, safety, and best interests of a

child or young adult while encouraging the emotional and developmental growth of the

child or young adult, that a substitute care provider shall use when determining whether

to allow a child or young adult to participate in extracurricular, enrichment, cultural, and

social activities.

(37) "Reasonable medical judgment" means a medical judgment that would be made by a

reasonably prudent physician, knowledgeable about the case and the treatment

possibilities with respect to the medical conditions involved.

(38) "Relative caregiver" means an individual who operates a home that has been approved by

the Department to provide care for a related child or young adult placed in the home by

the Department.

(39) "Seclusion" means the involuntary confinement of a child alone in a specifically designed

room from which the child is physically prevented from leaving.

(40) "Substitute care" means the out-of-home placement of a child or young adult who is in

the legal or physical custody and care of the Department.

(41) "Supervision plan" means a documented set of strategies that is developed to assist a

relative caregiver or foster parent in providing the additional support, observation,

direction, and guidance necessary to promote and ensure the safety and well-being of a

child or young adult.

(42) "Voluntary custody" means legal custody given to the Department, by written agreement,

by a parent or guardian of a child.

(43) "Voluntary Custody Agreement" means a written agreement between the Department and

the parent or guardian of a child, which transfers legal custody to the Department; the

Department assumes all parental authority and responsibilities that the agreement does

not specifically reserve to the parents or guardians, as permitted by state law; and the

Department provides the child substitute care or treatment, or both, if the family falls

within a circumstance described in OAR 413-020-0010(2)(a)-(c).

(44) "Voluntary Placement Agreement" means a binding, written agreement between the

Department and the parent or guardian of a child that does not transfer legal custody to

the Department but that specifies, at a minimum, the legal status of the child and the

rights and obligations of the parent or guardian, the child, and the Department while the

child is in placement.

(45) "Withholding of medically indicated treatment" means the failure to respond to an

infant's life-threatening condition.


(46) "Young adult" means a person aged 18 through 20 years.

Stat. Auth.: ORS 418.005

Stats. Implemented: ORS 109.056, 418.015, 418.270, 418.275, 418.280, 418.285















Voluntary Custody Agreement

413-020-0005

Purpose (Amended 10/01/15)

The purpose of OAR 413-020-0005 to 413-020-0050 is to describe:

(1) The circumstances in which parents or guardians and the Department may enter into a

Voluntary Custody Agreement concerning a child who is in the legal custody of the

parents or guardians; and

(2) The responsibilities of the parents or guardians and the Department in connection with

these agreements.



413-020-0010

Voluntary Custody Agreement (Amended 08/06/17)

(1) Under a "Voluntary Custody Agreement", the parent or legal guardian gives the

Department the legal custody of the child. The Department assumes all parental and legal

responsibilities that the agreement does not specifically reserve to the parents or legal

guardians as permitted under ORS 418.015 and becomes the child's legal custodian.

(2) It is appropriate for the Department to place a child in substitute care and provide

services if all of the following subsections apply:

(a) The parent or legal guardian requests the Department take custody of the child.

(b) The parent or legal guardian is immediately and temporarily unable to fulfill his

or her parental responsibilities.

(c) This inability will be alleviated with short-term placement when one of the

following conditions exists:

(A) The child cannot remain at home due to a temporary crisis in the family,

and cannot safely stay with a member of the extended family or another

responsible adult who is well known to the child.

(B) The parent or legal guardian is temporarily or will be temporarily unable

to fulfill parental responsibilities due to a diagnosed medical or mental

health condition.










VOLUNTARY CUSTODY AGREEMENTS OAR 413-020-0005 to 413-020-0050

(C) The child needs to be placed outside the home due to problems in the

family that could compromise the safety of a family member, and a

placement of limited duration in conjunction with intensive services is

likely to reunite the family and reduce safety concerns.

(3) A Voluntary Custody Agreement is not appropriate when the Department's Child

Protective Services has determined, within the past 12 months, that the parent or legal

guardian was the perpetrator of a founded disposition of child abuse or neglect or when

the parent or legal guardian is unwilling to be a permanent resource for the child.

(4) If the Department knows or has reason to know that the child is an Indian child, the

Department must comply with OAR 413-115-0050 and OAR 413-115-0090.

(5) A Child Welfare Program Manager must approve entering into a Voluntary Custody

Agreement.



413-020-0020

Legal Consent (Amended 08/06/17)

(1) Only a parent or guardian who has legal custody of the child may enter into a Voluntary

Custody Agreement (CF 1005).

(2) All persons who have legal custody of the child must sign the agreement unless one

person with legal custody of the child is missing.

(3) If one person with legal custody of the child is missing, all other persons with legal

custody of the child must sign the agreement and must provide the Department the

persons and places likely to have knowledge of the missing person's whereabouts. The

Department must immediately begin a reasonably diligent search to find the other person

with legal custody of the child to provide him or her notice of the agreement.

(4) The parent or guardian must provide information to the Department about insurance and

other financial resources to meet the medical, dental, and mental health needs of the child

by completing a Medical Resource Report Form (DHS 415H).

(5) If the Department knows or has reason to know the child is an Indian child, each parent

or Indian custodian who has legal custody must sign the Voluntary Custody Agreement in

a hearing before a judge of a court with appropriate jurisdiction. The child must be more

http://www.dhs.state.or.us/policy/childwelfare/manual_1/division_115.pdf









http://dhsresources.hr.state.or.us/WORD_DOCS/CE1005.doc

http://dhsforms.hr.state.or.us/Forms/Served/DE0415H.pdf


than 10 days old.


Stats. Implemented: ORS 418.015

413-020-0025

Developing the Family Support Services Case Plan when a Parent or Legal

Guardian Enters into a Voluntary Custody Agreement with Child Welfare (Adopted 03/20/07)

(1) The caseworker must develop a family support services case plan as described in OAR

413-030-0016 with the parent or legal guardian who signs a Voluntary Custody

Agreement.

(2) The caseworker must develop a visit and contact plan as described in OAR 413-070-0800

to 413-070-0880.

(3) The parent or legal guardian must agree to:

(a) Full and ongoing cooperation in developing the family support services case plan

as described in OAR 413-030-0006(2)(a)-(c) and making decisions for the child

based on the child's identified needs;

(b) Visit and financially support the child to the fullest extent possible; and

(c) Work cooperatively with the Department.



413-020-0040

Required Reviews (Amended 03/20/07)

Federal and state law, including the Adoptions and Safe Families Act (Pub. L. 105-89), require

review of the cases of all children placed in substitute care. The child placed by the Department

with a Voluntary Custody Agreement will be scheduled for Citizen Review Board and court

reviews pursuant to OAR 413-040-0100 to 413-040-0170.






http://www.dhs.state.or.us/policy/childwelfare/manual_1/i-b231.pdf














413-020-0045

Criteria for Continuing a Voluntary Custody Agreement After a Child

Reaches 18 Years of Age (Adopted 03/20/07)

(1) The Department determines that the child will need placement services after reaching 18

years of age and continues a Voluntary Custody Agreement after the child reaches 18

years per ORS 418.027(5) if:

(a) One of the conditions in OAR 413-020-0010(2)(a)-(c), which led the Department

to assume voluntary custody of the child, continues at the time of the child's 18th

birthday;

(b) The young adult agrees to the Department's continued assumption of all parental

and legal responsibilities that the Voluntary Custody Agreement does not

specifically reserve to the parents or legal guardians; and

(c) The District Manager approves the continuation of the Voluntary Custody

Agreement.

(2) The court must determine continued custody is in the best interests of the young adult and

approve the continuation of the Voluntary Custody Agreement every 180 days.

Stat. Auth.: ORS 418.005, 418.027

Stats. Implemented: ORS 418.015, 418.027

413-020-0050

Termination of Voluntary Agreement (Amended 08/06/17)

(1) Either the Department or a parent or legal guardian who signed the agreement may

terminate the agreement by providing 48 hours written notice. If an agreement continues

after the child reaches 18 years of age, a young adult may terminate the agreement by

providing 48 hours written notice.

(2) If a parent or legal guardian requests the termination of the voluntary agreement and

there is reason to believe the child will be unsafe if returned to the home of the parent or

legal guardian, the caseworker must report the information to a CPS screener.

(3) If the withdrawal of consent is by a parent or Indian custodian concerning a child who is

an Indian child under the Indian Child Welfare Act, who is in substitute care and the

subject of a "Voluntary Custody Agreement" with the Department, the following applies:

(a) The parent or Indian custodian may withdraw consent orally or in writing at any

time;










(b) An Indian child shall immediately be released to the parent or Indian custodian

upon withdrawal of a voluntary consent; and

(c) Notification to the court, and other actions are required when return of an Indian

child to the parent or Indian custodian would place the child in imminent danger

or harm.

Stat. Auth.: ORS 418.005, 418.027







Voluntary Placement Agreement

413-020-0060

Purpose (Adopted 03/20/07)

These rules, OAR 413-020-0060 to 413-020-0090, describe:

(1) The circumstances in which parents or legal guardians and the Department may enter into

a Voluntary Placement Agreement to place a child, who is in the legal custody of the

parents or legal guardians, for care or services from the Department; and

(2) The responsibilities of the parents or legal guardians and the Department in connection

with these agreements.



413-020-0070

Voluntary Placement Agreement Limitations (Adopted 03/20/07)

(1) Under a Voluntary Placement Agreement, the parent or legal guardian retains legal

authority over the child and is obligated to continue to exercise and perform all parental

authority and legal responsibilities, except those that the parent or legal guardian

specifically delegates to the Department by a binding agreement. The agreement

specifies, while the child is in placement, the legal status of the child and the rights and

obligations of the parent or legal guardian, the child, and the Department.

(2) The Department must use a Voluntary Placement Agreement (CF 499) under ORS

418.312 in all cases in which the sole reason for placing the child in a foster home, group

home, or institutional child care setting is the need to obtain services for the child's

emotional, behavioral, or mental disorder or developmental or physical disability.

(3) Under a Voluntary Placement Agreement, the Department has responsibility for the

child's placement and care.

(4) The parent or legal guardian who requests substitute care for the child through a

Voluntary Placement Agreement may enter into a child support agreement with the

Division of Child Support (DCS) or receive a child support order.

(a) The caseworker must inform the parent or legal guardian that he or she may enter

into a non-adversarial support agreement with DCS to discharge support








VOLUNTARY PLACEMENT AGREEMENT OAR 413-020-0060 to 413-020-0090

obligations. Other, existing child obligations of the parent or legal guardian are

not superseded by support agreements with DCS.

(b) The caseworker must provide the parent or legal guardian who signs the

Voluntary Placement Agreement with the "DCS Referral for Non-Adversarial

Support Agreement" (CF 496). The parent or legal guardian completes the form

and returns it to the caseworker. If the form is not returned to the caseworker

within 30 days, a support order may be entered.

(c) The caseworker must forward the completed form (CF 496) and a signed copy of

the Voluntary Placement Agreement to the Children's Benefits Unit of the

Department.

(5) The parent or legal guardian must provide information to the Department about insurance

and other financial resources to meet the medical, dental, and mental health needs of the

child by completing a Medical Resource Report Form (DHS 415H).

(6) A Child Welfare Program Manager must approve entering into a Voluntary Placement

Agreement.



413-020-0075

Legal Consent (Amended 08/06/17)

(1) Only a parent or guardian who has legal custody of the child may enter into a Voluntary

Placement Agreement.

(2) All persons who have legal custody of the child must sign the agreement unless one

person with legal custody of the child is missing.

(3) If one person with legal custody of the child is missing, all other persons with legal

custody of the child must sign the agreement and must provide the Department the

persons and places likely to have knowledge of the missing person's whereabouts. The

Department must immediately begin a reasonably diligent search to find the other person

with legal custody of the child to provide him or her notice of the agreement.

(4) If the child is an Indian child the Department must comply with OAR 413-115-0100.





http://dhsforms.hr.state.or.us/Forms/Served/DE0415H.pdf











413-020-0080

Developing the Family Support Services Case Plan and a Voluntary

Placement Agreement with the Department (Adopted 03/20/07)

(1) The caseworker must prepare the Voluntary Placement Agreement (CF 499), which must

specify the legal status of the child and the rights and obligations of the parent or legal

guardian, the child, and the Department.

(2) The caseworker must develop a family support services case plan (see OAR 413-030-

0016) with the parent or legal guardian who signs a Voluntary Placement Agreement.

(3) The caseworker must develop a visit and contact plan as described in OAR 413-070-0800

to 413-070-0880.

(4) The parent or legal guardian must agree to:

(a) Full and ongoing cooperation in the family support services case plan described in

OAR 413-030-0006(2)(a)-(c) and in making decisions for the child based on the

child's identified needs;

(b) Visit and financially support the child to the fullest extent possible; and

(c) Work cooperatively with the Department.



413-020-0085

Required Reviews (Adopted 03/20/07)

Federal and state law, including the Adoptions and Safe Families Act (Pub. L. 105-89), require

review of the cases of all children in substitute care. The child placed by the Department with a

Voluntary Placement Agreement will be scheduled for Citizen Review Board and court reviews

pursuant to OAR 413-040-0100 to 413-040-0170. Under state law:

(1) When the child remains in voluntary placement for more than 180 days, the juvenile

court must make a determination within the first 180 days of the placement that the

placement is in the best interests of the child.

(2) The juvenile court must hold a permanency hearing as provided in ORS 419B.476 to

determine the future status of the child no later than 14 months after the child's original

















voluntary placement and not less frequently than once every 12 months thereafter during

the continuation of the child's original voluntary placement.



413-020-0090

Termination of Voluntary Agreement (Amended 08/06/17)

(1) Either the Department or a parent or legal guardian who signed the Voluntary Placement

Agreement may terminate the agreement by providing 48 hours written notice. The child

support agreement may be terminated at the same time by sending a copy of the written

termination notice to the Children's Benefits Unit of the Department.

(2) If the parent or legal guardian requests the termination of the Voluntary Placement

Agreement and there is reason to believe the child is unsafe, the caseworker must report

the information to a CPS screener.

(3) OAR 413-115-0100(6) governs the withdrawal of consent by a parent or Indian custodian

concerning an Indian child who is in substitute care and the subject of a Voluntary

Placement Agreement with the Department.

(4) A Voluntary Placement Agreement ends when the child reaches 18 years of age.


Stats. Implemented: ORS 418.015, 418.312, 419C.080










https://www.oregonlegislature.gov/bills_laws/lawsstatutes/2013ors419c.html

Guardian and Legal Custodian Consents

413-020-0100


The purpose of OAR 413-020-0100 through 413-020-0170 is to:

(1) Define the Department’s authority as guardian and legal custodian of children in its care

or in the care of its agents;

(2) Specify how that authority will be exercised by the Department and its agents; and

(3) Specify requirements to be met when this authority is exercised.



413-020-0120

Responsibility of Staff to Secure a Legal Consent (Amended 10/01/15)

When the legal consent of a parent or guardian is needed for a child in the care and custody of

the Department, the caseworker shall secure the consent of the person authorized to approve the

proposed service or activity. Relevant information shall be provided to the authorized person to

assure the Department’s authority to consent, the need for and advisability of the service or

activity and, when feasible, the concurrence of parents and physical custodians.



413-020-0130

Department Authority in Voluntary Placement and Voluntary Custody

Agreements (Amended 10/01/15)

(1) When a parent or guardian of a child authorizes a voluntary placement with the

Department, the parent or guardian remains guardian of the child and retains legal

authority, and is obligated to continue to exercise and perform all parental duties and

legal responsibilities except those delegated to the Department by the signed CF 499

Voluntary Placement Agreement.











GUARDIAN AND LEGAL CUSTODIAN CONSENTS OAR 413-020-0100 to 413-020-0170

(2) In the event the parent or legal guardian is unavailable or unwilling to fulfill the

responsibilities of a guardian, the Department will petition the Juvenile Court and request

authority to provide essential services to the child.

(3) When a child is in the voluntary custody of the Department, the Department or the

physical custodian exercises the authority of a legal custodian as assigned in the CF 1005

Voluntary Custody Agreement.

(4) Voluntary custody agreements are covered in OAR 413-020-0005 to 413-020-0050 and

voluntary placement agreements are covered in OAR 413-020-0060 to 413-020-0090.



413-020-0140

Exercise and Delegation of Legal Authority (Amended 07/01/2020)

(1) When the Department has legal custody of a child through a Voluntary Custody

Agreement, a court order, or a Release and Surrender Agreement, the Department will

exercise its authority through Department staff and through delegation to other persons as

described in this rule.

(2) Physical Custodian. The Department delegates the following responsibilities to the

physical custodian. This delegation continues as long as the child or young adult is in the

legal custody of the Department and resides with the physical custodian. Any exception

to this rule must be given in writing to the custodian of the child or young adult and a

copy will be maintained in the child or young adult's case record with the Department.

The Department will delegate to the child’s physical custodian its authority to consent to:

(a) Enrollment and disenrollment of the child or young adult in regular public school;

assisting with selecting or changing class schedules; authorizing absence from

school; and enrollment in free and reduced meal programs. Consent for

standardized testing and assessment. Assessment and implementation of special

education, unless the child or young adult has a surrogate parent assigned (see

OAR 581-015-2000). School pictures, except those listed under subsection (2)(b)

of this rule;

(b) Routine medical care and dental care, including vaccinations and immunization;

routine examinations and lab tests;

(c) Short term inter-county travel;

(d) Application for work permits or releases; and






http://arcweb.sos.state.or.us/pages/rules/oars_500/oar_581/581_015.html


(e) Participation of the child or young adult in age-appropriate or developmentally

appropriate activities, including extracurricular, enrichment, cultural, and social

activities. When determining whether to allow a child or young adult to

participate, the physical custodian must apply the reasonable and prudent parent

standard. When applying the reasonable and prudent parent standard, the

physical custodian must consider:

(A) The age, maturity, and developmental level of the child or young adult;

(B) The nature and inherent risks of harm; and

(C) The best interest of the child or young adult based on information known

by the caregiver.

(3) The caseworker may exercise the Department’s consent authority to any action to which

the physical custodian may consent. In addition, the caseworker may exercise the

Department’s authority to give consent for the following;

(a) Photographs taken for publicity purposes or media promotions that may draw

attention to the child..

(b) Psychiatric or psychological evaluation, outpatient psychiatric or psychological

treatment, and behavioral rehabilitation services for the child.

(4) The Local Office Program Manager or designee. The Local Office Program Manager or

designee may exercise the Department’s consent authority to any action to which the

physical custodian or caseworker may consent. In addition, the Local Office Program

Manager or designee or Health and Wellness Services Program Manager may exercise

the Department’s authority to consent to all of the following actions with respect to the

children serviced by the Local Office.

(a) Emergency medical care and/or surgery, to include anesthesia

(b) Major medical and surgical procedures that are not extraordinary or controversial

to include anesthesia

(c) Gender affirming, fully and partially reversible medical interventions.

(5) District Manager or Designee. The District Manager or designee may exercise the

Department’s consent authority to any action to which the physical custodian,

caseworker, or Local Office Program Manager may consent. In addition, the District

Manager or designee may exercise the Department’s authority to consent to all of the

following actions with respect to the children serviced by the district:

(a) Enrollment in specialized schools, including private, charter, alternative,

international study program, GED, or home schools.


(b) Application for driver’s training, permits and license.

(c) Interstate travel and international travel.

(d) Examination by law enforcement agency (e.g. polygraphs, interrogations without

a warrant, etc.).

(e) Use of firearms for purpose of recreational hunting, target practice, and/or hunter

safety course.

(6) Health and Wellness Services Program Manager or the District Manager or designee

may consent to the following;

(a) Emergency medical care and/or surgery, to include anesthesia.

(b) Major medical and surgical procedures that are not extraordinary or controversial,

to include anesthesia.

(c) Admission to Secure Adolescent Inpatient Program (SAIP), Secure Children’s

Inpatient Program (SCIP), or a private hospital for purpose of psychiatric

treatment.

Stat. Auth.: ORS 161.390, 418.005

Stats. Implemented: ORS 109.640, 161.327, 161.336, 161.341, 161, 346, 161.365, 161.370,

418.005, 418.312

413-020-0150

Exercise and Delegation of Guardian Authority (Amended 07/01/2020)

(1) When the Department has legal custody of a child or young adult through a court order in

which the Department has specifically been given guardianship, or a Release and

Surrender Agreement, the Department will exercise its authority through Department

staff as described in this rule.

(2) District Manager or Designee: may exercise the Department’s authority to consent to the

following actions with respect to child or young adult served by that district:

(a) Enlistment of a child or young adult in the Armed Forces or the Job Corps; and

(b) Marriage.

(3) Department Child Permanency Program Manager: may exercise the Department’s

authority under ORS 109.325 to consent to the adoption of a child or young adult who is

in the permanent custody of the Department.

https://www.oregonlegislature.gov/bills_laws/ors/ors161.html















(4) Only the Health and Wellness Services Program Manager in consultation with the Child

Welfare Director or in their absence and in the event of an emergency a Deputy Director

for Child Welfare may consent to any of the following actions for a child:

(a) Termination of a pregnancy, except when a child – 15 years of age or older

exercises their statutory right to consent to their own termination of a pregnancy

(ORS 109.640).

(b) Extraordinary or controversial medical or surgical procedures, such as Do Not

Resuscitate Order (DNR), organ transplants, kidney dialysis, open heart surgery,

non-reversable gender affirming medical services, or any procedure involving

substantial life threat.

(c) Any medical or surgical procedure to which a legal parent or guardian of the

child or the child is opposed.

(d) Sterilization under ORS chapter 436, but only when such procedure is necessary

to protect the child’s life.

(5) Department Director, Director for Child Welfare or Deputy Director for Child Welfare,

may exercise the Department’s authority to consent to any action to which the physical

custodian, caseworker, Local Office Program Manager, and District Manager may

consent.


Stats. Implemented: ORS 109.325, 109.640, 418.312

413-020-0160

Actions Not Authorized (Amended 10/01/15)

(1) A Department employee may not consent to educational planning which is defined as the

responsibility of a parent or surrogate parent (see OAR 581-015-2000).

(2) A Department employee or agent may not exercise the Department’s authority to give

consent to the purchase of, or ownership of, a motor vehicle by a child in legal custody of

the Department. This prohibition does not prevent a child in the legal custody of the

Department from exercising the right to purchase or own a motor vehicle on his or her

own account.

(3) A Department employee may not co-sign or counter-sign any purchase contract for a

child or young adult in the Department’s custody.

(4) A Department employee may not accept responsibility or serve as conservator of a child

or young adult's property or estate.








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(5) A Department employee or agent may not consent to the sterilization of a child or young

adult, except pursuant to ORS chapter 436, and to save the child or young adult's life.



413-020-0170

General Provisions (Amended 10/01/15)

(1) The Department acknowledges the right of a minor 15 years of age or older to consent to

hospital care, medical and surgical diagnosis, or treatment without the consent of the

parent or guardian see ORS 109.640).

(2) The Department acknowledges the right of a minor 14 years of age or older to obtain,

without parental knowledge or consent, outpatient diagnosis or treatment of a mental or

emotional disorder or chemical dependency, excluding methadone maintenance, by a

physician (see ORS 109.675).

(3) Whenever Department staff exercise the agency's authority to authorize actions described

as the responsibility of a guardian under these rules, Department staff must:

(a) Consider the impact of the proposed action upon the welfare of the child, the

child's family and the community prior to deciding whether to consent to or

authorize the proposed action;

(b) Consult with the physical custodian of the child;

(c) When the child is not in the permanent custody of the Department, make

reasonable efforts to consult the child's parents or guardians about the action

proposed and consider the parents or guardians' preference concerning the action

proposed prior to making a decision to consent to or authorize the proposed action

unless there is cause to believe such consultation will be detrimental to the child;

and

(d) Prepare a brief written record of the circumstances of the action consented to

whenever the Department provides a written consent for actions defined as the

responsibility of a guardian. The written record and a copy of any consent made

in writing will be filed in the child's case record.

(4) In any case where Department staff consider it necessary or appropriate, they may notify

the juvenile court, or seek the court's concurrence, prior to consenting to or authorizing











any of the actions described in these rules with respect to children in the Department’s

custody.







CANS Screening and Enhanced Supervision

413-020-0200


The purpose of OAR 413-020-0200 to 413-020-0255, is to describe the responsibilities of the

Department to:

(1) Identify the supervision needs of a child or young adult in substitute care with a certified

family;

(2) Develop a supervision plan describing the actions and activities provided by a certified

family, the Department, and other individuals to meet the child or young adult's need for

enhanced supervision;

(3) Describe the responsibilities of the certified family and the Department when physical

restraint is used;

(4) Monitor the completion of behavior and crisis management training when physical

restraint is included in a child or young adult's supervision plan; and

(5) Conduct a CANS screening to determine the child’s or young adult’s eligibility for a level

of care payment for the purpose of negotiating or renegotiating guardianship assistance

pursuant to OAR 413-070-0900 to 413-070-0974 or negotiating or renegotiating

adoption assistance pursuant to OAR 413-130-0000 to 413-130-0130.



413-020-0230

Referral for and Review of the CANS Screening (Amended 11/1/2018)

(1) The Department must complete a CANS screening referral for a child or young adult in

its legal custody:

(a) Within the first 21 days of a child's initial placement in substitute care with a

certified family;

(b) When the child or young adult has continuously lived with a certified family, ten

months from the date of the most recent CANS screening and annually thereafter,

unless section (2) of this rule applies. Effective November 17, 2017, all children








CANS SCREENING AND ENHANCED SUPERVISION OAR 413-020-0200 to 413-020-0255

entering foster care and in the Department’s legal custody, regardless of level of

care, must be referred as described in this subsection; or

(c) Unless section (2) of this rule applies, five business days after a child or young

adult, whose initial placement in substitute care was a BRS placement, moves to

the home of a certified family.

(2) The caseworker of the child or young adult must consult with the Adoption Assistance

and Guardianship Assistance Unit prior to submitting a CANS screening referral when a

child's permanency plan is adoption or guardianship and the caseworker has submitted an

adoption assistance application or a guardianship assistance application.

(3) The caseworker of the child or young adult may, after consultation with and approval by

a supervisor, complete and submit to the Level of Care Manager or designee, a CANS

screening referral when a child or young adult returns to a placement with a certified

family after a BRS placement of six months or longer, unless section (2) of this rule

applies.

(4) If the caseworker of the child or young adult determines that a CANS rescreen is

necessary, the caseworker may, after consultation with and approval by a supervisor,

complete and submit to the Level of Care Manager or designee, a CANS rescreen referral.

(5) An adoption assistance coordinator or guardianship assistance coordinator may complete

and submit a CANS screening referral to the Level of Care Manager or designee under

the following circumstances:

(a) Written documentation of the current behavior and functioning of the child or

young adult has been submitted to the adoption assistance or guardianship

assistance coordinator by one of the following individuals:

(A) An adoptive family of the child or young adult, regardless of whether there

has been a previous CANS screening;

(B) A child's pre-adoptive family when the child is not in the legal custody of

the Department;

(C) A guardian of the child or young adult, regardless of whether there has

been a previous CANS screening; or

(D) A potential guardian of the child or young adult who has been approved

by a participating tribe.

(b) The written documentation submitted under subsection (a) of this section

demonstrates ongoing behaviors and functioning which have not improved with

recommended behavioral interventions, counseling or other professional services

and one of the following apply:


(A) A CANS screening has never been completed;

(B) A CANS screening has not been completed within the past twelve months;

or

(C) The child or young adult exhibits a significant, ongoing change in

behavior or functioning since the CANS screening that was completed

within the last 12-month period; and

(c) The adoptive family or guardian has requested a renegotiation of the adoption

assistance or guardianship assistance payment.

(6) The Level of Care Manager, or designee, within five business days of receipt of a CANS

screening referral submitted under section (3) or (4) of this rule:

(a) May approve a CANS screening after reviewing the referral, if the child or young

adult's behavior and functioning, as described in the referral, indicate a CANS

screening is needed to assess the need for enhanced supervision and a level of

care payment;

(b) Must notify the individual who submitted the CANS screening referral whether a

CANS screening has been approved and the basis for the decision; and

(c) If the referral is approved, must send the approved CANS screening referral to a

CANS screener.

(7) A CANS screener, upon receipt of the CANS screening referral submitted under section

(1), (2) or (3) of this rule must:

(a) Review the referral information;

(b) Contact the caseworker, when the child is in substitute care, to gather information

about the child or young adult's strengths and needs;

(c) Contact the certified family, pre-adoptive family, adoptive family, potential

guardian identified by a participating tribe, or guardian of the child or young

adult and gather information about the child or young adult's strengths and needs;

(d) Contact the child or young adult and other individuals who provide services to the

child or young adult as appropriate and gather sufficient information to

understand the child or young adult's strengths and needs to complete the CANS

screening; and

(e) When a child or young adult has current suicidal ideation or intent:


(A) Notify the child or young adult's caseworker or adoption or guardianship

assistance coordinator and, if applicable, notify the pre-adoptive family,

adoptive family, potential guardian, or guardian; and

(B) Immediately develop a supervision plan with the certified family when the

child or young adult is in substitute care with a certified family.

(8) After the CANS screener has gathered information regarding the child or young adult's

strengths and needs, as described in subsections (6)(a)-(d), the CANS screener rates each

element of a child or young adult's behavior and functioning on a scale of zero to three, in

a manner consistent with the principles of the Child and Adolescent Needs and Strengths

Comprehensive Screening Tool appropriate for the child or young adult's age. The CANS

screener documents the appropriate rating for each element and provides written

explanation for any rating of either two or three on an element that is a need and any

rating of zero or one on an element that is a strength.

(a) When the child is five years old or younger, the CANS screener rates the child

using the DHS 9601 - Child and Adolescent Needs and Strengths Comprehensive

Screening Tool Ages Birth through Five, dated November 2017, which by

reference is incorporated in OAR 413-090-0010(2)(f)(A).

(b) When the child or young adult is six years old or older, the CANS screener rates

the child or young adult using the DHS 9602 - Child and Adolescent Needs and

Strengths Comprehensive Screening Tool ages Six through Twenty dated

November 2017, which by reference is incorporated in OAR 413-090-

0010(2)(f)(B).

(c) The Department maintains these documents on the Department's website. Printed

copies of these documents may be obtained by contacting the Department of

Human Services, Child Welfare, ATTN: Level of Care Manager, 500 Summer

Street NE, E-93, Salem, OR 97301.

(9) The CANS screener must complete the activities in sections (6) and (7) and submit the

CANS screening results to the Level of Care Manager or designee within 15 business

days following the receipt of the referral.

(10) Within 10 business days of the receipt of the CANS screening results, the Level of Care

Manager or designee:

(a) Reviews the CANS screening results;

(b) Contacts the CANS screener when results appear inconsistent with the referral

information or documentation of a child or young adult's strengths and needs and

may instruct the CANS screener to:

(A) Gather additional information;

https://aix-xweb1p.state.or.us/es_xweb/DHSforms/Served/de9601.pdf?CFGRIDKEY=DHS%209601,9601,Child%20and%20Adolescent%20Needs%20and%20Strengths%20%28CANS%29%20Ages%20birth%20through%20five,,DE9601.pdf,,,,,,/es_xweb../FORMS/-,,/es_xweb../FORMS/-,

https://aix-xweb1p.state.or.us/es_xweb/DHSforms/Served/de9601.pdf?CFGRIDKEY=DHS%209601,9601,Child%20and%20Adolescent%20Needs%20and%20Strengths%20%28CANS%29%20Ages%20birth%20through%20five,,DE9601.pdf,,,,,,/es_xweb../FORMS/-,,/es_xweb../FORMS/-,


https://aix-xweb1p.state.or.us/es_xweb/DHSforms/Served/de9602.pdf?CFGRIDKEY=DHS%209602,9602,Child%20and%20Adolescent%20Needs%20and%20Strengths%20%28CANS%29%20Ages%206%20through%2020,,DE9602.pdf,,,,,,/es_xweb../FORMS/-,,/es_xweb../FORMS/-,




(B) Reapply the CANS ratings; and

(C) Resubmit the CANS screening results.

(c) Approves the CANS screening results unless subsection (b) applies; and

(d) Applies the CANS algorithm which by reference is incorporated in OAR 413-

090-0010(2)(f)(C) to the approved CANS screening results to determine whether:

(A) The child or young adult living with a certified family is eligible for a level

of care payment and requires enhanced supervision; or

(B) The child or young adult eligible for adoption assistance or guardianship

assistance qualifies for a level of care payment for the purpose of

negotiating or renegotiating an adoption assistance or guardianship

assistance payment.

(11) The Level of Care Manager or designee may approve a revision of the ratings of an

approved CANS screening when new or different information relevant to the correct

application of the CANS screening has been presented:

(a) In preparation for a contested case hearing requested under OAR 413-010-

0500(2)(a)-(c):

(b) During an informal conference under OAR 413-010-0520; or

(c) During the renegotiation of an adoption assistance agreement under OAR 413-

130-0075 or a guardianship assistance agreement under OAR 413-070-0969.

(12) The Level of Care Manager or designee sends the CANS screening results to the

following individuals:

(a) The child or young adult's caseworker and the certified family, with whom the

child or young adult is living, on behalf of the child or young adult; or

(b) The adoption assistance and guardianship assistance coordinator and child or

young adult's pre-adoptive family, adoptive family, guardian or the potential

guardian identified by a participating tribe.

(13) When the caseworker receives a child or young adult's CANS screening results, the

caseworker must:

(a) Contact the certified family to review the CANS screening results;

(b) When the CANS screening results indicated the child or young adult currently has

suicidal ideation or intent, review the supervision plan developed during the











CANS screening no later than one business day after the receipt of the CANS

screening results to determine whether the plan continues to be appropriate;

(c) Incorporate the needs and strengths identified in the CANS screening into the case

plan; and

(d) Determine whether a supervision plan must be developed, modified, or terminated

under OAR 413-020-0233 and 413-020-0236.

Stat. Auth.: ORS 418.005, 418.340

Stats. Implemented: ORS 418.005, 418.330, 418.335, 418.340

413-020-0233

When a Supervision Plan is Required (Amended 5/15/18)

(1) The caseworker must develop a supervision plan with the certified family with whom the

child or young adult lives within 30 days of:

(a) The receipt of the CANS screening results that indicates enhanced supervision is

necessary to maintain the safety and support the well-being of the child or young

adult and the child or young adult qualifies for a level of care payment; or

(b) When a child or young adult who has enhanced supervision needs and is

receiving a level of care moves from one certified family to another certified

family.

(2) A supervision plan is not required for a level of care payment determined for the purpose

of negotiating an adoption assistance or guardianship assistance payment.



413-020-0236

Development, Documentation, and Termination of a Supervision Plan (Amended 01/15/13)

(1) After the caseworker has reviewed the CANS screening results for a child or young adult

living with a certified family that indicates the child or young adult has enhanced

supervision needs and qualifies for a level of care payment, the caseworker must:

(a) Contact the certified family to explain the supervision needs identified in the

CANS screening results; and

















(b) During a meeting with the certified family, the child or young adult, as

appropriate, and others who may participate in a supervision plan, explain the

supervision requirements necessary to maintain the safety and support the well-

being of the child or young adult and develop a supervision plan that meets the

supervision needs of the child or young adult.

(A) If the child or young adult qualifies for Level 1 (moderate needs), the

supervision plan must require the certified family to provide an

environment with the additional support, direction, observation, and

guidance from the certified family necessary to ensure a child or young

adult's safety and well-being, beyond the level of supervision that typically

is required for a child or young adult of the same age.

(B) If the child or young adult qualifies for Level 2 (intermediate needs), the

supervision plan must require the certified family to provide a structured

environment, additional support, direction, observation, and guidance

necessary to ensure a child or young adult's safety and well-being, beyond

the level of supervision that typically is required for a child or young adult

of the same age.

(C) If the child or young adult qualifies for Level 3 (advanced needs), the

supervision plan must require the certified family to provide a highly

structured environment, additional support, direction, observation, and

guidance necessary to ensure a child or young adult's safety and well-

being, beyond the level of supervision that typically is required for a child

or young adult of the same age.

(2) The supervision plan must include:

(a) The supervision actions or activities that are to be provided by the certified family

and other individuals to meet the child or young adult's identified needs.

Examples of appropriate supervision actions or activities may include, but are not

limited to: proactive use of space, use of routine, structure of the environment,

positive reinforcement, and de-escalation techniques;

(b) The actions and assistance the Department will provide to support the certified

family in addressing the supervision needs of the child or young adult and to

maintain the child or young adult in the home;

(c) The actions the child or young adult will take to support the supervision plan;

(d) The persons responsible for monitoring the child or young adult's supervision

needs and the supervision actions and activities;

(e) How the persons responsible for monitoring the child or young adult's supervision

needs and the supervision actions and activities are to communicate with each

other; and


(f) A requirement that the supervision plan be reviewed during the first monthly

face-to-face contact described in OAR 413-080-0054 after the date the

supervision plan is signed by the individuals identified in section (3) of this rule.

(3) The supervision plan must be signed by:

(a) The caseworker;

(b) The certified family;

(c) The child or young adult, if able; and

(d) Any other individuals who are to provide specific actions or activities in the

supervision plan.

(4) The supervision plan must be approved by the caseworker's supervisor.

(5) A supervision plan may include physical restraint as a supervision action or activity only

if the certified family has completed the physical restraint training requirements

described in OAR 413-020-0240.

(6) A supervision plan that authorizes a certified family to use physical restraint must:

(a) Focus on intervention strategies that are designed to modify a child or young

adult's behavior without the need for physical restraint;

(b) Explain that a physical restraint is to be used only when the child or young adult's

behavior poses an imminent danger to self or others, and when no alternate

actions are sufficient to stop a child or young adult's behavior;

(c) Be approved by the Child Welfare program manager; and

(d) Require the certified family:

(A) To document and report the circumstances of each use of physical

restraint in writing as soon as reasonably possible after the use of physical

restraint on a form approved by the Department, which explains:

(i) The behavior that required the use of physical restraint;

(ii) The specific attempts to stop the child or young adult's behavior

without the use of physical restraint;

(iii) The time the physical restraint started; and

(iv) The time the physical restraint ended.



(B) To orally report to the child or young adult's caseworker or the

caseworker's supervisor within one business day of the physical restraint;

and

(C) To submit the documentation required in paragraph (A) of this subsection

to the child or young adult's caseworker within two business days after the

use of physical restraint.

(7) The caseworker must provide a copy of the signed supervision plan to the certified family

and the certified family's certifier, and file a copy in the Department's information

system.

(8) When a child or young adult has a supervision plan and the CANS screening results

indicate that the child or young adult no longer has enhanced supervision needs and no

longer qualifies for a level of care payment, the caseworker must:

(a) Terminate the supervision plan;

(b) Document in the Department's information system the date the supervision plan

terminated and the reason the plan terminated; and

(c) Notify the certified family and the certified family's certifier that the supervision

plan terminated and the reason the plan terminated.



413-020-0240

Use of Physical Restraint (Amended 12/28/11)

(1) A physical restraint may be used by a certified family when the behavior of a child or

young adult places the child or young adult or others in imminent risk of harm and only

when:

(a) Good judgment indicates that a physical restraint may safely be implemented;

and

(b) The certified family has received the individual Behavior and Crisis Management

Training in physical restraint specific to the supervision needs of the child or

young adult by Department trained staff.

(2) Physical restraint must be implemented with the least force necessary to prevent the risk

of harm to self or others and should end as soon as the risk of harm no longer exists.






(3) If the behavior of a child or young adult places the child or young adult or others in

imminent risk of harm, and good judgment indicates that a physical restraint cannot be

implemented safely, the certified family must call the local law enforcement agency to

request intervention. The certified family must:

(a) Orally report the incident to the caseworker and the caseworker's supervisor as

soon as reasonably possible;

(b) Document the incident in writing on a form approved by the Department; and

(c) Submit the completed form to the caseworker within two business days.

(4) If the child or young adult is injured during the incident, whether or not a physical

restraint is used, the certified family immediately must notify the Department's

emergency 24-hour contact.

(5) A certified family may not use mechanical restraint or seclusion of a child or young adult

in an emergency or at any other time as a supervision action or activity.

(6) Notwithstanding the training required in OAR 413-020-0255, when a situation arises and

the behavior of a child or young adult places the child or young adult or another

individual in imminent risk of harm and if good judgment indicates that a physical

restraint may safely be implemented, the certified family may use a physical restraint

even when:

(a) The certified family has not attended Behavior and Crisis Management Training;

or

(b) The child or young adult does not have a supervision plan.

(c) If physical restraint is used under this section, the certified family must document

and report the incident in accordance with the requirements of OAR 413-020-

0236(6)(c).



413-020-0245

Responsibilities in Monitoring a Child or Young Adult's Supervision in a

Certified Family (Amended 01/15/13)

(1) During each monthly face-to-face contact described in OAR 413-080-0054, in addition to

assessing the safety of the child or young adult, Department staff must determine:







(a) Whether the certified family is meeting the supervision needs of the child or

young adult.

(b) Whether the supervision needs of the child or young adult have changed.

(c) If there is a current supervision plan, whether the supervision actions and

activities described in the supervision plan are effective in meeting the child or

young adult's supervision needs.

(2) If, after assessing the safety of the child or young adult as described in OAR 413-080-

0054, the caseworker determines that the child or young adult currently is safe in the

home but his or her supervision needs are not being met, the caseworker must:

(a) Consult with the certified family's certifier or the certifier's supervisor to

determine if available resources or training are able to provide the additional

support the certified family may need to meet the child or young adult's

supervision needs;

(b) If there is a current supervision plan for the child or young adult, determine

whether the supervision plan should be revised, and if so, meet with the certified

family to revise the plan; and

(c) Determine whether there has been an observed, ongoing change in a child or

young adult's behavior or functioning such that the observed changes must be

documented and submitted with a CANS screening under referral OAR 413-020-

0230(2).

(3) The caseworker documents the monitoring activities described in this rule in the

Department's information system.



413-020-0255

Training and the Planned Use of Physical Restraint (Amended 12/28/11)

(1) The Department has approved and schedules Behavior and Crisis Management Training

as the standard training curriculum for any certified family who requires training on crisis

management. The training curriculum focuses on strengthening a certified family's

supervision skills.

(2) Before implementing a supervision plan that authorizes a certified family to use physical

restraint, the caseworker must:








(a) Consult with the certifier to confirm that the certified family has completed

Behavior and Crisis Management Training; and

(b) Contact the Level of Care Manager to schedule the certified family to receive

Behavior and Crisis Management Training, by Department-trained staff, in

physical restraint specific to the supervision needs of the child or young adult.

(3) A foster care coordinator or designee may approve comparable behavior and crisis

management training obtained by a certified family for a specific child or young adult in

place of Behavior and Crisis Management Training if:

(a) The training was selected by a school district and used in the school; or

(b) The training was approved by the Department of Human Services, Addictions and

Mental Health Division and used in a Children's Intensive Mental Health

Treatment Services program.







Investigation of Suspected Medical Neglect

413-020-0600

Purpose (Adopted 12/29/95)

(1) The purpose of these rules if to comply with Public Law 98-457, which requires that

procedures be established within Oregon's Child Protective Services (hereafter referred to

as CPS) program to respond to reports of suspected medical neglect, including reports of

withholding medically indicated treatment for disabled infants with life-threatening

conditions. The regulations indicate that the focus of the Department CPS work will be,

"as it is in responding to other reports of child abuse and neglect, to protect the child and

assist the family." Hospitals are encouraged to form review committees to assist with

medical and ethical dilemmas arising in the care of disabled infants with life-threatening

conditions. Due to the sensitive nature of these cases and the specialized skills required to

complete the investigations, the Department will designate a Child Welfare staff person

in each of the three cities having tertiary care centers (Portland, Eugene, and Medford) to

be a specialist in Medical Neglect investigations. These Medical Neglect Investigators,

along with the CPS program manager, will be available to provide telephone consultation

and investigations or reports alleging medical neglect of handicapped infants with life-

threatening conditions. The Medical Neglect Investigators will form a special

investigation "Team" with a Designated Consultant Neonatologist and a local CPS

caseworker.

(2) The federal regulations emphasize that parents are the decision makers concerning

treatment for their disabled infant based on advice and reasonable medical judgment of

their physician(s) with advice from the Hospital Review Committee, if one exists. It is not

the Department not the HRC, nor any other committee, who makes decisions regarding

the care and treatment for a child except in highly unusual circumstances where the

course treatment is inconsistent with applicable standards established by law.

(3) The legislation requires that appropriate nutrition, hydration, and medication shall always

be provided to the infant, and that the effectiveness of treatment shall not be based on

subjective opinions about the future "quality of life" of an infant. In response to a report

of medical neglect of a disabled infant with a life-threatening condition, Department’s

investigative role is to determine if the decision made to withhold treatment was based on

reasonable medical judgment consistent with the definition of "withholding of medically

indicated treatment." (See OAR 413-020-0000.)





INVESTIGATION OF SUSPECTED MEDICAL NEGLECT OAR 413-020-0600 to 413-020-0650

413-020-0620

Policy (Adopted 12/29/95)

Intake. Any person may make a report that a handicapped infant in a medical facility is not

receiving adequate and necessary medical care. Reports which indicate withholding of medical

treatment from disabled newborns with life-threatening conditions will be considered an

emergency and assigned for investigation within one hour. Each Child Welfare branch will

develop local procedures to assure that such reports received after normal work hours will be

promptly investigated. Anonymous reports will be accepted at Intake.

(1) Obtain from the reporting person as much of the following information as possible:

(a) Name and address of the hospital;

(b) Name and address of infant and infant's parents;

(c) The infant's name and birth date;

(d) The name of the infant's attending physician;

(e) The condition of the infant and in particular information regarding whether the

infant may die or suffer harm within the immediate future if medically indicated

treatment is withheld;

(f) The basis of the reporter's suspicion or belief that medically indicated treatment

or appropriate nutrition, hydration, or medication is being or will be withheld;

(g) Name of the person making the report, source of the information, position to have

reliable information (i.e. nurse, friend, family member, etc.), address and

telephone number.

(2) Criteria to determine if an investigation is indicated:

(a) Would the reported circumstances, if true, constitute "medical neglect";

(b) Is there reasonable cause to believe that medically indicated treatment is being

withheld? This must be based on the condition of the child, health care

professional's statements, information that the parents have refused to consent to

treatment, and consultation with the worker's supervisor;

(c) A Medical Neglect Investigator will be contacted to help determine if assignment

for a CPS investigation is indicated. (Consultation with a Designated Consultant

Neonatologist from a hospital other than the one where the infant is receiving

treatment may be utilized at this point.


(3) Reporting the Alleged Neglect. When a report of suspected medical neglect is received,

the local Law Enforcement Agency will be contacted per ORS 419B.020.



413-020-0630

Preliminary Investigation (Adopted 12/29/95)

(1) When a report of suspected medical neglect of a disabled infant with life-threatening

conditions is received and assigned for investigations, the CPS caseworker will

immediately contact a Medical Neglect Investigator for consultation and assistance in

initiating a preliminary investigation. The Medical Neglect Investigator will have the

responsibility to determine the role/activities of the CPS caseworker and the Medical

Neglect Investigator during preliminary investigation and "on site" investigation of a

report. The Medical Neglect Investigator will conduct the investigations whenever

possible.

(2) During the preliminary investigations, the CPS caseworker or Medical Neglect

Investigator will contact the Designated Consultant Neonatologist from a hospital other

than the one where the infant is receiving care, for consultation and assistance. (Names of

consultant neonatologists are available from the CPS program manager).

(a) The Medical Neglect Investigator (or Designated Consultant Neonatologist) shall

contact the hospital liaison, advise that person of the nature of the reported

suspected medical neglect, and request assistance to obtain the following

information:

(A) Whether the infant is in the hospital;

(B) The name and location of the infant's parents;

(C) The medical condition of the infant, i.e., does the infant have a life-

threatening condition;

(D) The nature of the care and treatment being provided to the infant and what,

if any, additional or alternative treatment could be provided;

(E) If the infant's parents are in agreement with the care and treatment being

provided or if they have refused to consent to recommended treatment;

(F) If there is a critical time pressure and thus a need for immediate court

action;

(G) The analysis of the HRC or other review body;





(H) Whether the attending physician has consulted with other medical

professionals concerning the care and treatment of the infant and whether

the medical professionals are in agreement with the care and treatment

being given.

(b) If treatment is indicated and recommended by the physician and the parents are

refusing to consent to treatment, then court action should be immediately initiated

or further counseling with the parents pursued. In addition to filing a petition in

juvenile court, Child Welfare shall request that a guardian ad litem (GAL) or

court appointed special advocate (CASA) be appointed for the child.

(c) Criteria for continuing or closing preliminary investigation:

(A) If the facts confirmed by the treatment team indicate any of the following

circumstances, then the investigation shall be terminated and the case

closed: (The facts should be documented in the case file.)

(i) The infant is chronically and irreversibly comatose;

(ii) The provision of treatment would merely prolong dying, not be

effective in ameliorating or correcting all the infant's life-

threatening conditions, or otherwise be futile in terms of survival

of the infant;

(iii) The provision of treatment would be virtually futile in terms of

survival of the infant and the treatment itself under such

circumstances would be inhumane.

(B) Where there remains doubt about the hospital's compliance with state

laws, parents refuse to authorize medically-indicated treatment, or there is

a need for additional information to substantiate a conclusion, the

investigation should be continued.



413-020-0640

Investigation (Adopted 12/29/95)

When additional information is necessary to substantiate a conclusion to the medical neglect

report, the Medical Neglect Investigator shall form a special investigative team with a consultant

neonatologist from a hospital other than the one where the infant is receiving care, a local CPS

caseworker and any other necessary professionals such as a nutritionist or the local district

attorney. The on-site investigation shall be completed in the shortest possible time.




(1) The Medical Investigator, with the assistance of the special investigation team members

and designated hospital liaison, will complete the following:

(a) Interview treating physicians and others involved in the treatment;

(b) Arrange as early as possible meeting with HRC or other hospital review boards or

committees. Determine at minimum the following: Did the HRC verify the

diagnosis? How were the parents involved in the process? What treatment

alternatives exist?

(c) Review medical records. The parents shall be requested to sign a release of

information to allow CPS investigation and/or medical consultant to review

records. If determined necessary, court intervention may be used to give access to

medical records;

(d) Interview parents (after first determining with hospital social worker

appropriateness and context for interviewing parents) to determine the parent's

understanding of the child's condition and treatment alternatives, the decisions

they have made, and the basis for those decisions.

(2) When necessary, the Medical Neglect Investigator may take the following actions:

(a) Make an on-site visit to the medical facility to observe the care and treatment

being provided to the infant;

(b) If an alternative diagnosis was not entertained, and no consultants brought in, or

there was not a procedure for reviewing the diagnosis and treatment

recommendation, then the investigator may wish to arrange for an independent

medical consultant and/or exam. The Medical Neglect Investigator shall

recommend to the parent(s) that an independent medical examination or

evaluation be performed. If the parent(s) do not consent, the specialist will seek a

court order to obtain an independent medical examination or evaluation.

(3) Concluding the Investigation

(a) Following the investigation, the Medical Neglect Investigator will determine:

(A) Whether the report of suspected medical neglect of the handicapped infant

with life-threatening conditions is valid. Information from the HRC or

consulting physicians, including the Designated Consultant Neonatologist,

shall be used to determine whether the treating physician exercised

reasonable medical judgment. The reasonable medical judgment of the

treating physician may differ from that of other physicians. Grounds for

overriding the refusal of the parents of the infant to consent to medical

care and treatment exist only if any reasonable medical judgment would

be that treatment is medically indicated. The parents' refusal to consent

shall be respected if the attending physician, the Review Committee, or a

consulting physician finds that treatment is not medically indicated;


(B) Whether further action should be taken by the Department, and if there is a

basis for juvenile court jurisdiction.

(b) If the parents of the infant refuse to consent to the medical care and treatment

found to be necessary and adequate by the attending physician and the HRC, or by

another consulting medical professional, or the attending physician refuses to

provide treatment, Child Welfare shall initiate the filing of a petition in juvenile

court on behalf of the infant requesting the court to take jurisdiction of the infant

so that medically indicated treatment may be provided. Child Welfare will also

request that a Guardian Ad Litem (GAL) or Court Appointed Special Advocate

(CASA) be appointed for the child. The caseworker will document these actions

in the case record;

(c) If the infant's parents do not desire medical treatment beyond that being provided

and if the reasonable medical judgment of the attending physician, HRC, or other

consulting medical professional is that medically indicated treatment is being

provided, the Medical Neglect Investigator will document this agreement in the

case record. The CPS caseworker will close the case and take no further action;

(d) If the infant's parents desire medical care or treatment for the infant which is not

being provided by the attending physician or the medical facility, the Medical

Neglect Investigator will advise the parents of their option to seek another

medical opinion or additional medical resources. The Medical Neglect

Investigator shall document the advice given the parents in the case record, the

caseworker will close the case and take no further action;

(e) The Child Welfare caseworker shall assist the parent(s) with referrals to support

groups, community educational resources, and agencies which provide services

for disabled infants and their families, and to agencies with financial resources for

medical and rehabilitative services;

(f) Following completion of the investigation, the Medical Neglect Investigator shall

notify the assistant administrator for the Program Operations by telephone of the

report, the investigation and the actions taken. The telephone report is to be

followed by a written report and documented in the case record.



413-020-0650

Annual Information Update (Adopted 12/29/95)

Each local Child Welfare branch manager shall contact each hospital in their county and obtain

the name, title, and telephone number of the designated hospital liaison who is responsible for




coordination, consultation, and notification of Child Welfare of cases of suspected medical

neglect. The branch managers shall update this information annually.





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